Hormonal Birth Control Methods

Note: Information provided on this page is for reference only,
please seek medical assistance when in doubt

Hormonal contraception refers to birth control methods that primarily act on the endocrine
system and are mostly composed of steroid hormones. Originally the hormonal method was introduces
as an oral contraceptive pills in 1960’s and in the ensuing decades many other delivery methods
have been developed, although the oral and injectable methods are by far the most popular. Currently
they are commercially available only for women, although hormonal contraceptives for men are being
clinically tested.

About 18% of the world's contraceptive users rely on hormonal methods. The hormonal contraception
is highly effective when taken on the prescribed schedule, with pregnancy rates of less than 1% per year
and when used perfectly can ensure pregnancy rate upto 0.3% or less.

Hormonal contraceptives work by inhibiting ovulation and fertilization. They are available
in a number of different forms, including oral pills, implants under the skin, injections, patches,
IUDs and a vaginal ring. They are of two types, the combined contraceptive and the progestogen-only.

Combined methods which contain both an estrogen and a progestin work by suppressing ovulation
and thickening cervical mucus. While Progestogen-only methods contain only progesterone or one
of its synthetic analogues (progestins) which reduce the frequency of ovulation, most of them rely more
heavily on changes in cervical mucus.

Combined hormonal contraceptionThe most popular form of hormonal contraception is the combined oral contraceptive pill (COCPs) commonly
known as the pill - is taken once a day for 21 days followed by a seven-day break, although other
regimens are also used.

The contraceptive patch is applied to the skin and worn continuously. A series of three patches
are worn for one week each, and then the user takes a one-week break.

NuvaRing is worn inside the vagina. A ring is worn for three weeks. After removal, the user
takes a one-week break before inserting a new ring. As with COCPs, other regimens may be used with
the contraceptive patch or NuvaRing to provide extended cycle combined hormonal contraception.

A combined injectable contraceptive is a shot given once per month.

Progestogen-only hormonal contraceptionThe progestogen only pill (POP) is taken once per day within the same three-hour window. Several
different formulations of POP are marketed. A low-dose formulation is known as the minipill. Unlike
COCPs progestogen-only pills are taken every day with no breaks or placebos. For women not using
ongoing hormonal contraception, progestogen-only pills may be taken after intercourse as emergency
contraception. There are a number of dedicated products sold for this purpose.

Hormonal intrauterine contraceptives are known as intrauterine systems (IUS) must be inserted
by a health professional this may be used for up to five years. While a copper-containing intrauterine
device (IUD) may be used as emergency contraception

Depo Provera is an injection that provides three months of contraceptive protection. Noristerat
is another injection; it is given every two months. The perfect use first-year failure rate of the
injectable progestin, Depo-Provera, is 0.2%; the typical use first failure rate is 6%.

Contraceptive implants are inserted under the skin of the upper arm, and contain progestogen only.
Two types are available; Jadelle (Norplant 2) consists of two rods that release a low dose of
hormones. It is effective for five years. Implanon is a single rod that releases a moderate dose
of hormones. It is effective for three years.

OrmeloxifeneOrmeloxifene is a selective estrogen receptor modulator (SERM) in the form of pill that is taken
once per week.

Note: Hormonal contraceptives are associated with some health risk and women are advisable
to consult their local health center before using them